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https://www.readbyqxmd.com/read/29033075/multi-drug-resistant-organism-infections-in-a-medical-icu-association-to-clinical-features-and-impact-upon-outcome
#1
E E Magira, S Islam, M S Niederman
OBJECTIVE: To define clinical features associated with Intensive Care Unit (ICU) infections caused by multi-drug resistant organisms (MDRO) and their impact on patient outcome. DESIGN: A single-center, retrospective case-control study was carried out between January 2010 and May 2010. SETTING: A medical ICU (MICU) in the United States. PATIENTS: The study included a total of 127 MDRO-positive patients and 186 MDRO-negative patients...
October 12, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/29024878/impact-of-outlier-status-on-critical-care-patient-outcomes-does-boarding-medical-intensive-care-unit-patients-make-a-difference
#2
Danish Ahmad, Katherine Moeller, Jared Chowdhury, Vishal Patel, Erika J Yoo
PURPOSE: To evaluate the impact of outlier status, or the practice of boarding ICU patients in distant critical care units, on clinical and utilization outcomes. MATERIALS AND METHODS: Retrospective observational study of all consecutive admissions to the MICU service between April 1, 2014-January 3, 2016, at an urban university hospital. RESULTS: Of 1931 patients, 117 were outliers (6.1%) for the entire duration of their ICU stay. In adjusted analyses, there was no association between outlier status and hospital (OR 1...
October 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28971499/restoration-of-resident-sleep-and-wellness-with-block-scheduling
#3
James Bordley, Algene G Agustin, Mohamed A Ahmed, Raeesa Khalid, Anthony M Paluso, Bethany S Kobza, Aaron W Spaugy, Jonathan Emens, Sima S Desai, Akram Khan
CONTEXT: Block scheduling during residency is an innovative model in which in-patient and ambulatory rotations are separated. We hypothesised that this format may have a positive impact on resident sleep and wellness in comparison with a traditional format. METHODS: We performed a single-centre, cross-sectional, observational study of residents rotating in the medical intensive care unit (MICU). Residents were observed for 4 weeks at a time: internal medicine (IM) residents were observed for 3 weeks in the MICU followed by 1 week in an ambulatory context, and non-IM residents were observed for 4 weeks in the MICU...
October 3, 2017: Medical Education
https://www.readbyqxmd.com/read/28968409/a-brief-intervention-for-preparing-icu-families-to-be-proxies-a-phase-i-study
#4
Alison E Turnbull, Caroline M Chessare, Rachel K Coffin, Dale M Needham
BACKGROUND: Family members of critically ill patients report high levels of conflict with clinicians, have poor understanding of prognosis, struggle to make decisions, and experience substantial symptoms of anxiety, depression, and post-traumatic stress regardless of patient survival status. Efficient interventions are needed to prepare these families to act as patient proxies. OBJECTIVES: To assess a brief "patient activation" intervention designed to set expectations and prepare families of adult intensive care unit (ICU) patients to communicate effectively with the clinical team...
2017: PloS One
https://www.readbyqxmd.com/read/28912909/the-use-of-tranexamic-acid-for-upper-gastrointestinal-bleeding-by-medical-and-surgical-intensivists-a-single-center-experience
#5
Jason Chertoff, Grant Lowther, Hassan Alnuaimat, Ali Ataya
BACKGROUND: Tranexamic acid (TXA) may be beneficial in the management of upper gastrointestinal bleeding (UGIB). We sought to investigate how frequently intensivists at our academic institution use TXA for patients with UGIB, and to investigate whether the utilization rate of TXA differs between surgical and medical intensivists, and provide an updated literature review on the subject. METHODS: We performed a retrospective cohort study of patients admitted for UGIB to the surgical intensive care unit (SICU) and the medical intensive care unit (MICU) at our academic healthcare facility (University of Florida Health - Shands Hospital) from January 1, 2013 to December 31, 2016...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28892925/impact-of-antibiotic-stewardship-program-on-prescribing-pattern-of-antimicrobials-in-patients-of-medical-intensive-care-unit
#6
Nishal Shah, Anuradha Joshi, Barna Ganguly
INTRODUCTION: Rising concerns about antimicrobial resistance and inadequate development of effective new anti-infective drugs have stimulated universal efforts to strengthen infection-control interventions. Antimicrobial stewardship is a rational, systematic approach to promote the optimal selection, dosing, and duration of therapy for antimicrobial agents throughout the course of their use in order to improve the outcomes. AIM: Since in Shree Krishna Hospital (SKH), Antibiotic Stewardship Program (ASP) was first implemented in 2013, this study was planned to assess any change in antimicrobial use before and after implementation of ASP and to study the rate and pattern of antimicrobial use in medical ICU...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28874631/the-prognostic-role-of-microsatellite-instability-in-colorectal-cancer-patients
#7
Bogdan V Micu, Octavian Andercou, Stefan C Vesa, Carmen M Micu, Tudor R Pop, Nicolae Constantea
BACKGROUND: Data from the literature regarding the prognostic role of DNA mismatch repair system (MMR) in colorectal cancer are still controversial. AIM: The aim of the study was to identify the prognostic role of different phenotypic, clinical and pathological characteristics in microsatellite unstable vs. microsatellite stable colorectal cancer in terms of survival and disease free interval. METHODS: We conducted a retrospective study that included a total of 103 patients who underwent curative surgery for colorectal cancer...
July 28, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28865338/impact-of-restarting-home-neuropsychiatric-medications-on-sedation-outcomes-in-medical-intensive-care-unit-patients
#8
Mary K La, Melissa L Thompson Bastin, Jenee T Gisewhite, Carrie A Johnson, Alexander H Flannery
PURPOSE: This single-center, retrospective cohort study investigated the effects of timing of initiating home neuropsychiatric medications (NPMs) on sedation-related outcomes. MATERIALS AND METHODS: Subjects included adult medical intensive care unit (MICU) patients who had an NPM on their admission medication list; intubated before or on arrival to the intensive care unit (ICU); and were on benzodiazepine-based sedation. The intervention assessed was the timing of the initiation of home NPMs: early (≤5days) vs...
July 29, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28845494/quantitative-doppler-in-musculoskeletal-ultrasonography-suboptimal-performance-of-both-experienced-and-in-training-sonographers-in-selection-of-the-highest-doppler-signal-image-from-cine-loops
#9
Florian Berghea, Violeta Vlad, Lavinia Palanciuc, Mihaela Micu, Violeta Bojinca, Florentin Vreju, Luminita Enache, Monica Copotoiu, Alexandra Kosevoi, Teodora Serban, Denisa Stanciu, Mihai Abobului, Andreea Borangiu, Camelia Elena Berghea, Andra Rodica Balanescu, Ruxandra Ionescu
AIMS: Doppler ultrasonography assessment is mandatory nowadays for the complete description of rheumatic disease activity. Initially it was performed in semi quantitative way but recently the (fully) quantitative assessment is gaining more interest. In quantitative assessment, the ratio between total colorized and total pixels (CTR) is computed for the whole image or just for the region of interest (ROI). The frame with the highest amount of Doppler signal (also called worst case scenario image - WCSI) is usually the only one analyzed...
May 10, 2017: Medical Ultrasonography
https://www.readbyqxmd.com/read/28814430/the-2017-eular-standardised-procedures-for-ultrasound-imaging-in-rheumatology
#10
Ingrid Möller, Iustina Janta, Marina Backhaus, Sarah Ohrndorf, David A Bong, Carlo Martinoli, Emilio Filippucci, Luca Maria Sconfienza, Lene Terslev, Nemanja Damjanov, Hilde Berner Hammer, Iwona Sudol-Szopinska, Walter Grassi, Peter Balint, George A W Bruyn, Maria Antonietta D'Agostino, Diana Hollander, Heidi J Siddle, Gabriela Supp, Wolfgang A Schmidt, Annamaria Iagnocco, Juhani Koski, David Kane, Daniela Fodor, Alessandra Bruns, Peter Mandl, Gurjit S Kaeley, Mihaela Micu, Carmen Ho, Violeta Vlad, Mario Chávez-López, Georgios Filippou, Carmen Elena Cerón, Rodina Nestorova, Maritza Quintero, Richard Wakefield, Loreto Carmona, Esperanza Naredo
BACKGROUND: In 2001, the European League Against Rheumatism developed and disseminated the first guidelines for musculoskeletal (MS) ultrasound (US) in rheumatology. Fifteen years later, the dramatic expansion of new data on MSUS in the literature coupled with technological developments in US imaging has necessitated an update of these guidelines. OBJECTIVES: To update the existing MSUS guidelines in rheumatology as well as to extend their scope to other anatomic structures relevant for rheumatology...
August 16, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28810207/intermediate-care-to-intensive-care-triage-a-quality-improvement-project-to-reduce-mortality
#11
David N Hager, Pranav Chandrashekar, Robert W Bradsher, Ali M Abdel-Halim, Souvik Chatterjee, Melinda Sawyer, Roy G Brower, Dale M Needham
PURPOSE: Medical patients whose care needs exceed what is feasible on a general ward, but who do not clearly require critical care, may be admitted to an intermediate care unit (IMCU). Some IMCU patients deteriorate and require medical intensive care unit (MICU) admission. In 2012, staff in the Johns Hopkins IMCU expressed concern that patient acuity and the threshold for MICU admission were too high. Further, shared triage decision-making between residents and supervising physicians did not consistently occur...
August 3, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28800734/a-t-type-channel-calmodulin-complex-triggers-%C3%AE-camkii-activation
#12
Hadhimulya Asmara, Ileana Micu, Arsalan P Rizwan, Giriraj Sahu, Brett A Simms, Fang-Xiong Zhang, Jordan D T Engbers, Peter K Stys, Gerald W Zamponi, Ray W Turner
Calmodulin (CaM) is an important signaling molecule that regulates a vast array of cellular functions by activating second messengers involved in cell function and plasticity. Low voltage-activated calcium channels of the Cav3 family have the important role of mediating low threshold calcium influx, but were not believed to interact with CaM. We find a constitutive association between CaM and the Cav3.1 channel at rest that is lost through an activity-dependent and Cav3.1 calcium-dependent CaM dissociation...
August 11, 2017: Molecular Brain
https://www.readbyqxmd.com/read/28792169/sofa-score-and-critically-ill-elderly-patients
#13
Vishal Gupta, Niteen D Karnik, Dhiraj Agrawal
OBJECTIVE: To study correlation between SOFA Score and Outcome in Elderly Patients admitted In Intensive Care Unit. METHODS: A single centre prospective observational study in Medical Intensive Care Unit (MICU) of large teaching Institute. A total of 84 elderly patients were studied and the outcome was correlated with SOFA Score at admission and 48 hours after admission. RESULTS: Elderly patients constituted 10.94% (84 out of 764) of total MICU admissions...
July 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28751028/toxic-metals-biomonitoring-based-on-prey-predator-interactions-and-environmental-forensics-techniques-a-study-at-the-romanian-ukraine-cross-border-of-the-black-sea
#14
Stefan-Adrian Strungaru, Mircea Nicoara, Carmen Teodosiu, Dragos Micu, Gabriel Plavan
Marine cross-border areas are ideal for monitoring pollutants so as to increase ecosystems protection. This study was conducted at the Romanian-Ukraine border of the Black Sea to reveal evidence of contamination with toxic metals based on biomonitoring of: cadmium, lead, total chromium, nickel and copper at different water depths and prey-predator interactions, combined with environmental forensics techniques of biological sampling and separation in witnesses size groups. The species used were Mytilus galloprovincialis L...
July 25, 2017: Marine Pollution Bulletin
https://www.readbyqxmd.com/read/28730246/spontaneous-cholecystocutaneous-fistula-as-a-primary-manifestation-of-gallbladder-adenocarcinoma-associated-with-gallbladder-lithiasis-case-report
#15
Bogdan Vasile Micu, Octavian Aurel Andercou, Carmen Maria Micu, Valentin Militaru, IonuŢ Isaia Jeican, Cătălina Ileana Bungărdean, Stelian ŞtefăniŢă Mogoantă, Dan Radu Miclăuş, Tudor Radu Pop
Spontaneous cholecystocutaneous fistula (SCF) is a rare complication of neglected calculous biliary disease and also an extremely rare complication of gallbladder neoplasm. This pathology has become even rarer because of prompt diagnosis and expedient surgical intervention for gallstones. So far, there is one published report of a SCF due to gallbladder adenocarcinoma. We present the case of a woman aged 87 years, admitted to the Vth Department of Surgery, Clinical Municipal Hospital of Cluj-Napoca (Romania) for a tumoral mass located in the epigastrium...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28726037/can-a-collaborative-subspecialty-antimicrobial-stewardship-intervention-have-lasting-effects
#16
Kaushal B Shah, Ramzy H Rimawi, Mark A Mazer, Paul P Cook
OBJECTIVE: We previously demonstrated the benefit of direct, daily collaboration between infectious disease (ID) and critical care practitioners (CCP) on guideline adherence and antibiotic use in the medical intensive care unit (MICU). In this post-intervention review, we sought to establish whether the effect on antibiotic use and guideline adherence was sustainable. DESIGN: A retrospective review of 87 patients, admitted to the 24-bed MICU, was done 3 (n = 45) and 6 months (n = 42) after the intervention...
July 19, 2017: Infection
https://www.readbyqxmd.com/read/28723703/management-of-chest-pain-in-the-french-emergency-healthcare-system-the-prospective-observational-epidoultho-study
#17
Sandrine Charpentier, Sebastien Beaune, Luc Marie Joly, Abdo Khoury, François-Xavier Duchateau, Raphael Briot, Bertrand Renaud, François-Xavier Ageron
OBJECTIVE: The aim of this paper was to describe the epidemiology, and diagnostic and therapeutic strategies that emergency physicians use to manage patients presenting with chest pain at all three levels of the French emergency medical system - that is, dispatch centres (SAMUs: the medical emergency system), which operate the mobile intensive care units (MICUs), and hospitals' emergency departments (EDs), with a focus on acute coronary syndrome (ACS). PATIENTS AND METHODS: All patients with chest pain who contacted a SAMU and/or were managed by a MICU and/or were admitted into an ED were included in a 1-day multicentre prospective study carried out in January 2013...
July 18, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28718341/diagnostic-yield-and-outcomes-of-computed-tomography-of-the-head-in-critically-ill-nontrauma-patients
#18
Fabian Finkelmeier, Sophie Walter, Kai-Henrik Peiffer, Anjali Cremer, Andrea Tal, Thomas Vogl, Stefan Zeuzem, Stephan Fichtlscherer, Mireen Friedrich-Rust, Jörg Bojunga, Harald Farnik
BACKGROUND: Computed tomography of the head (HCT) is a widely used diagnostic tool, especially for emergency and trauma patients. However, the diagnostic yield and outcomes of HCT for patients on medical intensive care units (MICUs) are largely unknown. METHODS: We retrospectively evaluated all head CTs from patients admitted to a single-center MICU during a 5-year period for CT indications, diagnostic yield, and therapeutic consequences. Uni- and multivariate analyses for the evaluation of risk factors for positive head CT were conducted...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28668919/feasibility-of-continuous-actigraphy-in-patients-in-a-medical-intensive-care-unit
#19
Biren B Kamdar, Daniel J Kadden, Sitaram Vangala, David A Elashoff, Michael K Ong, Jennifer L Martin, Dale M Needham
BACKGROUND: Poor sleep and immobility are common in patients in the medical intensive care unit (MICU) and are associated with adverse outcomes. Interventions to promote sleep and mobilization in the MICU are gaining popularity, but feasible instruments to measure their effectiveness are lacking. Actigraphy may be useful for large-scale, continuous measurement of sleep and activity, but its feasibility in MICU patients has not been rigorously evaluated. OBJECTIVE: To evaluate the feasibility of continuous actigraphy measurement in consecutive MICU patients...
July 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28651311/outcomes-of-very-elderly-%C3%A2-80-years-critical-ill-patients-in-a-medical-intensive-care-unit-of-a-tertiary-hospital-in-korea
#20
Seung Hun Lee, Tae Won Lee, Sunmi Ju, Jung-Wan Yoo, Seung Jun Lee, Yu Ji Cho, Yi Yeong Jeong, Jong Deog Lee, Ho Cheol Kim
BACKGROUND/AIMS: This study evaluated clinical characteristics and outcomes in very elderly (≥ 80 years of age) critical-ill patients admitted to a medical intensive care unit (MICU) in a regional single tertiary hospital. METHODS: We retrospectively evaluated prospectively collected data in the MICU for the period of December 2011 to May 2014. Patients were divided into ≥ 80 and < 80 years of age and clinical characteristics and outcomes were compared among these patients...
July 2017: Korean Journal of Internal Medicine
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